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Biomedical subjects

P K Domoto

Publications and source records attributed to P K Domoto.

At least 19 recordsLinked to original sources
PubMed2000

Effectiveness of local anesthesia in pediatric dental practice.

BACKGROUND: Pain control in dental treatment for children is very important. The purpose of this study is to describe the characteristics of local anesthetic use by pediatric dentists and to examine factors related to its effectiveness in children. METHODS: The authors observed 361 patients in 17 pediatric dental practices in Washington state while each child received restorative or surgical dental treatment. The authors recorded data concerning local anesthetic use and effectiveness. The children's mean age was 87 months, and 181 (50.1 percent) of the patients were girls. A pediatric dentist observer rated each child's anxiety before the initial injection of local anesthetic and the effectiveness of pain control during restorative treatment. The observing dentist asked the treating dentist about the effectiveness of pain control after completion of treatment. RESULTS: Forty-two of 361 children (11.6 percent) were observed to experience ineffective pain control. Fourteen of 17 dentists (82.4 percent) were observed to have at least one patient in whom pain control was ineffective. Lidocaine (2 percent with 1:100,000 epinephrine) was used by 15 of 17 dentists (88.2 percent) and in 312 of 361 cases (86.4 percent). The average amount of agent was one cartridge (36 milligrams of lidocaine). Children who were anxious, who had symptoms before treatment, and who underwent more invasive operative and endodontic procedures were more likely to experience ineffective pain control. CONCLUSIONS: The data suggest that painful treatment is relatively frequent even in specialized pediatric practice. Variability in general practice is likely to be greater. CLINICAL IMPLICATIONS: The incidence of ineffective pain control may be less if clinicians use methods to reduce anxiety and perioperative infection and symptoms.

Anesthesia, Dental↗
PubMed2000

The role of the pediatrician in the oral health of children: A national survey.

OBJECTIVES: To assess pediatricians' knowledge, attitudes, and professional experience regarding oral health, and to determine willingness to incorporate fluoride varnish into their practices. BACKGROUND: Poor and minority children suffer disproportionately from dental caries and have limited access to dental care. In a recent analysis of national survey data, the General Accounting Office reported that poor children had 5 times more untreated decay than did children from higher income families. Untreated decay can lead to problems with eating, speaking, and attending to learning. Children who are poor suffer 12 times the number of restricted activity days because of dental problems, compared with more affluent children. Despite higher rates of dental decay, poor children had one half the number of dental visits compared with higher income children in 1996. Medicaid's Early Periodic Screening Diagnosis and Treatment (EPSDT) program is intended to provide regular dental screenings and appropriate treatment but has apparently played a limited role in improving access to dental care for poor children. According to a report by the Office of the Inspector General of the Department of Health and Human Services, only 20% of children under 21 years of age, who were enrolled in Medicaid and eligible for EPSDT, actually received preventive dental services. By increasing their involvement in oral health prevention during well-child care visits, pediatricians may be able to play an important role in improving the dental health of their patients who have difficulty obtaining access to professional dental care. However, it is unclear to what degree pediatricians are knowledgeable about preventive oral health and the extent to which they may already be participating in prevention and assessment. Also, little is known about the incidence of dental problems in pediatric practice, and whether pediatricians perceive barriers to their patients' receiving professional dental care. Finally, it is important to know how pediatricians value the promotion of oral health and whether they would be willing to take on additional activities aimed at its improvement. We addressed these questions in a national survey of pediatricians. DESIGN: We surveyed a national sample of 1600 pediatricians randomly selected from the American Medical Association Master File to assess their knowledge, current practice, and opinion on their role in the promotion of oral health; experience with dental decay among patients and in referring patients for professional dental care; and willingness to apply fluoride varnish. RESULTS: Of 1386 eligible survey recipients, 862 returned surveys for a response rate of 62%. Respondents reported seeing dental problems regularly. Two thirds of respondents observed caries in their school-aged patients at least once a month. Of the respondents, 55% reported difficulty achieving successful dental referrals for their uninsured patients and 38% reported difficulty referring their Medicaid patients. More than 90% of the respondents agreed that they had an important role in identifying dental problems and counseling families on the prevention of caries. Moreover, respondents were interested in increasing their involvement: 74% expressed a willingness to apply fluoride varnish in their practices. One half of the respondents, however, reported no previous training in dental health issues during medical school or residency, and only 9% correctly answered all 4 knowledge questions. CONCLUSION: Access to dental care and unmet dental health needs are serious, under addressed problems for poor and minority children in the United States. In promoting preventive oral health, pediatricians benefit all children and particularly the underserved. We know of 2 states, Washington and North Carolina, that have acknowledged, through the provision of reimbursement, that pediatricians have a unique opportunity at well-child care visits to provide caries prevention c

Child↗
PubMed1998

Inhalation of 30% nitrous oxide impairs people's learning without impairing people's judgments of what will be remembered.

Many hypotheses have been proposed to account for the effects of nitrous oxide on memory, with one emerging possibility being that it has a global effect on memory-related functioning. This possibility was explored by examining the effects of nitrous oxide on memory performance and on the accuracy of people's judgments about their memory performance. Participants inhaled 30% nitrous oxide or a placebo gas while items were studied and while judgments were made about the likelihood of recall for each item. Next, all participants inhaled the placebo during paired-associate recall. Although administration of nitrous oxide during study impaired recall, it did not affect the predictive accuracy of the metacognitive judgments. These results provide pharmacological evidence for a distinction between memory and metamemory.

Adolescent↗
PubMed1988

Results of a dental fear survey in Japan: implications for dental public health in Asia.

The purpose of this investigation was to initiate the study of dental fear in Japan. 415 college students, aged 18-22 yr were surveyed. A standardized questionnaire which has been used in the United States was translated into Japanese and was administered to the students. More than 80% of those surveyed reported some dental fear. Six to 14% of the students reported extreme fear of the dentist. The majority of the subjects admitted that they delayed making dental appointments due to fear. Muscle tension was the most common physiological symptom reported. The dental drill and needle were the most fear-provoking stimuli.

Adolescent↗
PubMed1986

The use of nitrous oxide in the treatment of children: results of a controlled study.

The sequential analysis of behavior has begun to show that the behavior of the dentist is a major influence on the fear-related behaviors of children, even when N2O is used. The moment-to-moment behaviors of the dentist influence the child's behaviors. Certain behaviors of dentists, such as distraction, appear to be effective especially when the N2O is being administered.

Analysis of Variance↗
PubMed1979

A pilot study using remote broadcasting equipment to provide instruction in pedodontics.

This study investigates the value of remote broadcasting equipment in instruction in pedodontics. Twenty students, between their junior and senior years, were randomly chosen and videotaped during an operative dentistry appointment with a child. Ten students reviewed and critiqued their own tapes immediately after the clinic session. Ten students received instruction using remote broadcasting equipment in an attempt to provide cues and immediate feedback. Results indicate the usefulness of remote broadcasting equipment as a new pedagogic technique in pedodontics.

Child Behavior↗
PubMedDate not supplied

A study of dental caries and risk factors among Native American infants.

Seventy-seven infants, ages twelve to thirty-six months, were examined in a Women Infant Children (WIC) program at the Tulalip Health Center, Marysville, Washington. All parents/caregivers completed questionnaires, which consisted of twenty-nine questions regarding children's feeding, general care, and dental health behavior. After completing questionnaires, dental examinations were conducted with mouth mirror and explorer by one dentist. Results indicated overall caries prevalence of 46.8 percent (26 percent for twelve to eighteen months, 56 percent for eighteen to twenty-four months and 56 percent for twenty-four to thirty-six months groups). The overall average number of carious teeth per child (deft) was 2.09 (0.83, 2.17 and 2.86, in order). Caries in children was significantly associated with following factors; bottle fed now (63.9 percent vs 29.3 percent, p = .00), giving bottle as baby falls sleep (82.4 percent vs 61.0 percent, p = .03), and 3 times or more snacks between meals (73.5 percent vs 40.0 percent, p = .01). Similarly, brushing behavior was related to caries. These results suggest that the present population was at risk for caries and that feeding patterns beyond bottle use appear to be behavioral risk factors in the prevalence of infant caries in this population.

Bottle Feeding↗
PubMedDate not supplied

A longitudinal assessment of predictive value of a caries activity test in young children.

A longitudinal study was conducted in Okayama, Japan to investigate the predictive value of a caries activity test (Cariostat). The subjects were 100 children who participated in routine dental examinations at 18, 24 and 36 months. Results indicated caries prevalence of 9% at 18 months, 21 percent at 24 months and 70 percent at 36 months. Cariostat scores at each age were correlated with dmft at 36 months and with whether or not child was caries-free at 36 months. Cariostat scores at each age showed good validity (sensitivity + specificity) for whether or not child was caries-free at 36 months. These results indicated that caries activity test, Cariostat, was effective for predicting caries occurrence in young children.

Child, Preschool↗
PubMedDate not supplied

A study of baby bottle tooth decay and risk factors for 18-month old infants in rural Japan.

Caries risk factors in rural Japan were identified for 637 children age eighteen months. Oral examinations, behavioral risk questionnaires and caries activity tests (Cariostat) were utilized. Results indicated an overall 13.7 percent prevalence of decay and strong correlations between Cariostat and caries status. Of the behavioral risk factors, weaning from breast feeding was most closely related with caries status. All factors resulted in correct classifications of Cariostat score and caries status. These results suggest that a screening of high risk infants can be accomplished by using the questionnaire and Cariostat test.

Bottle Feeding↗
PubMedDate not supplied

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Aversive Therapy↗